A Proposed Classification for the Spectrum of Vanishing Gastroschisis

Abstract

Infants born with gastroschisis in association with intestinal atresia are well described. We are the proposing the classification of vanishing gastroschisis. In this series of six cases, at one end of the spectrum is an infant having gastroschisis with a much narrower defect on the right side of umbilicus. The ischemic bowel loops were connected to bowel inside the abdomen by a fibrous band compressing the exposed bowel mesentery. On the other end of spectrum, an infant having extensive bowel atresia and complete closure of abdominal wall defect (gastroschisis) detected on antenatal ultrasound. These cases should raise awareness of this devastating complication in prenatal management of gastroschisis.

Keywords

gastroschisis - intestinal atresia - abdominal wall defect - vanishing gut

• References

• 1 Ashburn DA, Pranikoff T, Turner CS. Unusual presentations of gastroschisis. Am Surg 2002; 68 (8) 724-727
• 2 Hoyme HE, Higginbottom MC, Jones KL. The vascular pathogenesis of gastroschisis: intrauterine interruption of the omphalomesenteric artery. J Pediatr 1981; 98 (2) 228-231
• 3 Celayir S, Beşik C, Sarimurat N, Yeker D. Prenatally detected gastroschisis presenting as jejunal atresia due to vanishing bowel. Pediatr Surg Int 1999; 15 (8) 582-583
• 4 Louw JH, Barnard CN. Congenital intestinal atresia; observations on its origin. Lancet 1955; 269 (6899) 1065-1067
• 5 Tibboel D, Raine P, McNee M , et al. Developmental aspects of gastroschisis. J Pediatr Surg 1986; 21 (10) 865-869
• 6 Aktuğ T, Hoşgör M, Akgür FM, Olguner M, Kargi A, Tibboel D. End-results of experimental gastroschisis created by abdominal wall versus umbilical cord defect. Pediatr Surg Int 1997; 12 (8) 583-586
• 7 Shaw A. The myth of gastroschisis. J Pediatr Surg 1975; 10 (2) 235-244
• 8 Duhamel B. Embryology of exomphalos and allied malformations. Arch Dis Child 1963; 38 (198) 142-147
• 9 deVries PA. The pathogenesis of gastroschisis and omphalocele. J Pediatr Surg 1980; 15 (3) 245-251
• 10 Hoyme HE, Jones MC, Jones KL. Gastroschisis: abdominal wall disruption secondary to early gestational interruption of the omphalomesenteric artery. Semin Perinatol 1983; 7 (4) 294-298
• 11 Curry JI, McKinney P, Thornton JG, Stringer MD. The aetiology of gastroschisis. BJOG 2000; 107 (11) 1339-1346
• 12 Bhatia AM, Musemeche CA, Crino JP. Gastroschisis complicated by midgut atresia and closure of the defect in utero. J Pediatr Surg 1996; 31 (9) 1288-1289
• 13 Gornall P. Management of intestinal atresia complicating gastroschisis. J Pediatr Surg 1989; 24 (6) 522-524
• 14 Caniano DA, Brokaw B, Ginn-Pease ME. An individualized approach to the management of gastroschisis. J Pediatr Surg 1990; 25 (3) 297-300